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Gendered Risks Are Cause For Pause In ACT's End Of Life Choices Inquiry

This afternoon our Managing Director, Rachael Wong, addressed the Select Committee on End of Life Choices in the ACT. Below is her opening statement from the hearing. The full transcript of her submission will be uploaded to our website once it is available.

Women’s Forum Australia is an independent think tank striving to create pro-woman cultural change in Australian society through research, education, mentoring and advocacy, with a particular focus on addressing behaviour that is harmful and abusive to women.

When addressing various issues affecting women, we take particular care to examine the root of a problem, and to try to find solutions for this, rather than simply treating its symptoms. This is especially relevant to the issue of assisted dying.

Our concern for the dignity, freedom, rights andwellbeing of women, ultimately comes from a deeper concern for the dignity, freedom, rights and wellbeing of all people, and the families and communities that they are a part of.

We believe that in raising up women, we also raise up men, children, families, communities and society.

With that in mind, I would like to firstly reiterate the start of our research note which highlights general concerns around instituting euthanasia and assisted suicide as standard medical practices, which will affect both men and women and our society as a whole. These include:

the normalisation of suicide;

the risk of coercion or pressure to end one’s life;

the risk of non-voluntary and involuntary euthanasia;

the inevitable expansion of conditions for eligibility as seen overseas dependent on how the state views which lives are valuable and which are no longer worthwhile;

the risk of people’s lives being ended based on inaccurate medical diagnoses or prognoses;

the concern that those suffering may be inhibited from giving truly informed consent to their lives being ended;

a decreased incentive to develop palliative care;

and the fundamental shift in the practice of medicine and the nature of the doctor-patient relationship.

These concerns can be summed up as critical concerns about whether decisions to end patients’ lives will be truly autonomous, free and voluntary under a legalised assisted dying regime, whether such a regime will devalue the lives of certain citizens (particularly those who are old, sick, disabled or depressed), and whether it will overlook and prevent us from addressing the real issues that cause individuals to want to end their lives and extending our genuine care and compassion to them when they need it most.

However, what is especially concerning for us, is that these concerns, particularly those around autonomy, may disproportionately affect women.

As our research note explains, there is evidence to suggest that there are certain gender-specific risks that may thwart women’s autonomy in end of life decisions and make them particularly vulnerable to assisted dying laws.

We already know that as a result of various biological and cultural factors, women are disproportionately affected by issues like elder abuse, homelessness, other economic disadvantage, domestic violence, sexual exploitation, and depression. These issues could contribute towards women wanting to end their lives because of the suffering caused by such circumstances. It is also reasonable to consider that they may form part of a more subtle pressure on women to end their lives.

For example, if a woman is suffering financially and feels like a burden to her loved ones, is her decision to end her life really a free, autonomous choice, or is it the result of entrenched economic disadvantage outside her control?

If a woman requests to end her life but has been suffering elder abuse, domestic violence, or some other form of abuse, which may also have led to depression or other psychological issues, is the most compassionate and reasonable response to respect her decision to die, or to provide her with the help and support she needs to deal with these underlying problems?

It may be maintained that we are talking about people with terminal illnesses, but I would like to point out that women with terminal illnesses can still be affected by such issues, which could ultimately affect their ability to make a truly autonomous choice when it comes to assisted dying. Furthermore, we have seen in places like the Netherlands that the requirement for having a terminal illness does not endure once the line has been crossed to allow assisted suicide and euthanasia.

We believe that there are enough serious concerns, questions and doubts raised by the literature on this issue and the evidence coming out of jurisdictions where assisted dying is already legal, to deter the ACT from introducing similar laws. There is at least cause for pause to further consider the gendered risks we have raised and to undertake further research before any legislative change.